Bunion Treatment

 
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A bunion is a fairly common deformity that takes place at the base of the big toe, right where it connects to the foot. The condition develops on account of the bones on each side of the metatarsophalangeal joint (MTPJ)—the joint that acts as a hinge for your toe—and can result in a rather uncomfortable situation. When the phalange bone of the toe starts angling inwards, the MTPJ begins protruding out of place. This creates the signature bump on the inside edge of the foot.

The prominent sign of this condition is that unusual bump, but an inward-angled big toe is also a clue that a bunion has developed. Other symptoms that accompany the condition include redness, swelling, pain, and irritation. On account of the abnormal positioning, corns and calluses are more likely to form in the area. Wearing shoes or even walking can be difficult or painful.

Bunion Development

Typically, bunions begin as a bump or outward bend of the big toe that is only a cosmetic concern. However, the misaligned, outward-bending toe stretches the ligaments that connect the foot bones and pulls against the tendons, gradually drawing the toe farther out of line.

Over time, the big toe continues to twist until it no longer lines up properly with its corresponding metatarsal and the end of the metatarsal may become enlarged.

Pressure from the first toe can result in deformity of the metatarsophalangeal joint in the second toe, pushing it toward the third toe. In some cases, the second toe may ride over or under the big toe. At this point, the range of motion in the big toe is decreased, which is a condition called hallux limitus.

What Really Causes Bunions

This is actually the most common toe deformity humans develop. While this is a condition that can happen to individuals from virtually any demographic, females have bunions more frequently than other groups.

There is a bit of a misconception when it comes to the prominence of this particular condition among the female population. Many are quick to attribute this phenomenon to the shoes women wear – yet that’s not entirely accurate.

It’s easy to understand why people might think it is, though. After all, stylish women’s footwear are often high-heeled models, like stilettos and pumps.

podiatrist bunion exam
Those shoes obviously elevate the heel, which then places extra pressure on the forefoot. On top of that, they usually feature narrow, pointy fronts. So the conditions seem ripe for bunion development.

What that theory doesn’t take into consideration is the fact bunions are often related to structural instability and imbalance, especially relating to connective tissues.

Men have connective tissues holding the metatarsophalangeal (MTP) joint together as well, so why is this more of a problem for women?

The answer to this could come down to a hormone known as relaxin.

Relaxin plays an integral role in a female’s ability to give birth by relaxing ligaments. The intended ligaments are primarily found, naturally, in the pelvic region, but relaxin can affect connective tissues elsewhere in the body – including down in feet.

Bunions often run in families, which suggests that the inherited shape of the foot may predispose one to them.

Specifically, flat feet are unstable and cause overpronation, which frequently causes bunions to form. Bodyweight is repeatedly transferred to the hallux (big toe) while walking, and in flat feet, this transfer of weight allows certain muscles to become stronger than others. The overpowering of muscles causes the toe to bend and deform.

Improper shoes (tight, pointy-toed, or high-heeled footwear) exacerbate the underlying cause of flat, unstable feet – and are not actually a cause!

Bunion Treatment – Conservative and Surgical

It’s often thought that the only way to treat a bunion is with surgical intervention – this is only partially correct. Sure, the only way to correct a wayward toe is with bunion surgery, but we have conservative treatment methods that can relieve symptoms and reduce the likelihood of progression.

When it comes to nonsurgical care for a bunion, we are looking at options like:

  • Shoe choices – Finding footwear that offers wide, deep toe boxes can be beneficial. This avoids placing too much pressure or friction on the affected area.
  • Ice – Icing a bunion for about fifteen minutes at a time can help to reduce pain and inflammation. It is important to make sure that ice is not placed directly on the skin. Wrap it in a thin cloth or towel to avoid skin damage.
  • Medication – As always, consult with our office before administering medicine so we can provide recommendations and appropriate dosage amounts, but non-steroidal anti-inflammatory drugs (NSAIDs) are useful for managing pain and inflammation.
  • Custom orthotics – Our office can create a special pair of orthotic devices that are custom-fitted to an affected foot. This treatment is used to redistribute pressure on the foot and keep it away from the forefoot area.

With regards to bunion surgery, there are various surgical techniques we might use. That said, severe deformities may need procedures to be performed for both affected soft tissues and bones. In the case of mild bunions, we may recommend only an osteotomy procedure (more on this in a second).

Either way, the good news about surgical intervention for bunions is that it’s often rather effective. In fact, a majority of patients report improvement and favorable outcomes.

Professional Bunion Treatment at Premier Podiatry Group

For more information on this common toe deformity—or to request an appointment for bunion treatment (conservative or surgical)—contact Premier Podiatry Group today!

Either call our office (814) 472-2660 or simply take a moment and use our online form to connect with us right now.